A STUDY OF CRANIAL NERVE INVOVEMENT IN PATIENTS WITH GUILLAIN�BARRE’ SYNDROME

DR. P. Musakhan; DR. S. Sreevani; DR. K.S. Amaravathi; DR. M. Bhargavi Devi

Volume : VI, Issue : IX, September - 2016

A STUDY OF CRANIAL NERVE INVOVEMENT IN PATIENTS WITH GUILLAIN�BARRE’ SYNDROME

Dr. P. Musakhan, Dr. S. Sreevani, Dr. K. S. Amaravathi, Dr. M. Bhargavi Devi

Abstract :

Objectives: To study the incidence and presentation of cranial nerves involvement in patients with Guillain–Barre’ Syndrome(GBS) from a tertiary care centre at Hyderabad. Methodology: This is a retrospective study of patients with GBS attending Osmania General Hospital between Jan 2012 to August2016.75 patients of GBS were studied in detail including history, clinical examination especially for cranial nerves and investigations. Patients were treated with intravenous(IV) methyl prednisolone, IV Immunoglobulins(IVIG) and plasmapharesis depending on the patient’s condition and outcome was observed. Pattern of Nerve Conduction Studies (NCS) in all patients at admission and outcome was studied. Results: A total 75 patients were included in the study. The age of patients ranged between 16–70 yrs with a male to female ratio of 2:1. Quadriparesis was the commonest presentation (74. 6 %) followed by paraparesis (25. 3 %), unilateral facial nerve palsy (9.3 %), bilateral facial palsy(6.6%), bulbar palsy (8%) and oculomotor palsy(1.3%). NCS showed acute motor and sensory axonal neuropathy (AMSAN) in 55(73.3%) patients, acute motor axonal neuropathy(AMAN) in 7(9.3 %) patients, acute inflammatory demyelinating polyradiculoneuropathy (AIDP) in 9(12 %) and secondary axonal in 4(5.3%) patients. Conclusion: GBS is more common in 21–40 yrs age group, 19(25.3%) patients had cranial nerve palsies, out of 19 patients with cranial nerve palsies 12 (63.1 %) patients had facial palsy, 6 (31.5 %) patients had bulbar palsy, and 1 (5.2 %) patient had oculomotor palsy. Only 3 patients developed respiratory paralysis and needed ventilatory support and 1 patient expired and 68 patients recovered